Premature atherosclerosis-related central nervous system involvement in two cases of systemic lupus erythematosus

Patients with systemic lupus erythematosus are prone to premature atherosclerosis. Though atherosclerosis-related coronary artery disease in young lupus patients has been reported, there are a few reports on related central nervous system (CNS) involvement in systemic lupus erythematosus. It is imperative to differentiate CNS-atherosclerosis from active lupus as aggressive immunosuppressive treatment is often the choice for the latter. Two cases of young lupus patients with transient loss of consciousness and cerebral infarctions are reported, in whom atherosclerosis was considered as the major risk factor. Both were premenopausal young women who had more than 10-year histories of lupus. Besides CNS symptoms, they did not have any sign suggesting lupus flare. Both had hyperlipidemia without family histories, and carotid ultrasound showed bilateral atherosclerotic plaques. Both responded to treatment with statins and antiplatelet agents.